CocoJenL 1 Posted January 21, 2014 Who is it that decides whether or not a person has to do the 6 month nutrition class? Is it the Surgeon or the Insurance company? Share this post Link to post Share on other sites
DangerousD 77 Posted January 21, 2014 Sometimes it is the doctor, but usually it is the insurance company that is driving the 6 month diet trial. 1 Jerzygurl reacted to this Share this post Link to post Share on other sites
Recycled 2,182 Posted January 21, 2014 Who is it that decides whether or not a person has to do the 6 month nutrition class? Is it the Surgeon or the Insurance company? It's not really a diet trial or nutrition class. "It's a six month opportunity for you to change you mind or give up and the insurance won't have to pay" - trial. 5 DestinClair1983, Rena's got this, Sofficial and 2 others reacted to this Share this post Link to post Share on other sites
JerseyGirl68 1,172 Posted January 21, 2014 (edited) Who is it that decides whether or not a person has to do the 6 month nutrition class? Is it the Surgeon or the Insurance company? My surgeon's office followed what my insurance dictated. At first they required the 6 month supervised diet. About 2 months in, that requirement was dropped and I could move forward. Good luck! Edited January 21, 2014 by JerseyGirl68 Share this post Link to post Share on other sites
Photo925 100 Posted January 21, 2014 My insurance dictated the 6 months of classes that are required before. What I find interesting is that the surgeon decides if the sleeve or bypass is the proper surgery for you....after only one visit!! Im glad that they said that we get to have some say in the matter, but the surgeon can override us after only one meeting.....I just hope my surgeon thinks that the sleeve is the better choice for me!! Share this post Link to post Share on other sites
CocoJenL 1 Posted January 21, 2014 I spoke with a representative regarding the list of requirements I'll need to get done and they have been acting like they work for dang secret service or something. Just keep telling me to wait until my surgeon submits the auth and ill find out then. They wont give me any info at all and its becoming very frustrating. I just feel like I could at least BEGIN the nut classes instead of waiting another month if I was sure its required Share this post Link to post Share on other sites
CocoJenL 1 Posted January 21, 2014 I was NOT aware that the surgeon decided which surgery is best for you! Lap and is definitely outta the question for me, and the RNY is not something I've considered, just because its so complicated, however, I suppose in would go with it if I had no other option Share this post Link to post Share on other sites
Photo925 100 Posted January 21, 2014 I think every insurance and situation is different....my insurance still technically offers that lap band, but they have made it very clear that they do maybe one a year and it really isn't an option. I have Kaiser and even they way that they do things from county to county here is different. My sister did the Kaiser program and had 3 months of classes, while Im doing the same program and have six months of classes just because Im one county south of her and thats how they do it here. The waiting can be good to. gives you time to wrap your head around everything. In my sisters classes, there were actually quite a few people who lost weight while in the classes and opted out of the surgery cause they felt they had a good jump start on the weight loss (or they couldn't give up soda and just quit Share this post Link to post Share on other sites
Sofficial 162 Posted January 22, 2014 My insurance company required that I completed a 6 month supervised diet program with a physician or dietitian. Share this post Link to post Share on other sites
Tropical.Lover 24 Posted January 24, 2014 It's not really a diet trial or nutrition class. "It's a six month opportunity for you to change you mind or give up and the insurance won't have to pay" - trial. EXACTLY !!!!! Share this post Link to post Share on other sites
angiev8159 0 Posted February 15, 2014 Does anyone ha Bcbs of ks? My doctor wrote a letter telling them I have reflux sugar levels are messed up and. My blood pressure was up. I hope that is all it takes. I thought they had to have documents of it all Share this post Link to post Share on other sites
geekmom 4 Posted February 19, 2014 Does anyone ha Bcbs of ks? My doctor wrote a letter telling them I have reflux sugar levels are messed up and. My blood pressure was up. I hope that is all it takes. I thought they had to have documents of it all This is interesting! Is it possible to push an approval through if something like that happens? I know there is a criteria that must be met before most insurance companies that DO cover it will even consider it. But what about the ones that don't cover it at all? Can it be a situation where "this needs to happen or else"? Share this post Link to post Share on other sites
survivingsleever 33 Posted February 19, 2014 Hi all, I have BCBS of MI and I am required to do a 6 month nutrition evaluation/weigh in, sleep study, receive a letter of support from my pcp, & psy evaluation. Nutrition eval could be omitted if I had 6 month documentation from a medical professional. I'm truly grateful for the waiting period. You really have to train your body for the lifestyle change. Share this post Link to post Share on other sites
30SOMETHING 16 Posted March 3, 2014 Hi all, I have BCBS of MI and I am required to do a 6 month nutrition evaluation/weigh in, sleep study, receive a letter of support from my pcp, & psy evaluation. Nutrition eval could be omitted if I had 6 month documentation from a medical professional. I'm truly grateful for the waiting period. You really have to train your body for the lifestyle change. I also have BCBS of Michigan. If you go with St. John hospital, I think the wait maybe less.if that's an option for you. I am going with St. John and the only hoop that I have to jump through is have an approval by my regular doctor and then submit for approval. Hopefully, I will be having surgery in the next 3 weeks. Share this post Link to post Share on other sites
survivingsleever 33 Posted March 3, 2014 I am going through St. John Macomb-Oakland. That's interesting, you don't have to jump like I did. Do you have documentation of you weight for 6 months?? That's is the only exception I am aware of. I'm scheduled 3/14! Good luck to you =) Share this post Link to post Share on other sites